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Cosmetic and
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dentistry

Dentist Won’t Match Implant Crown

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I have had the dental crown placed on my implant three different times and none of them matched the adjacent teeth. My dentist said I’m being too picky and my tooth color is between A1 and A2 and I will never be satisfied. She’s refusing to do it again. I hinted I will try somewhere else and she said that puts my dental implant in danger of coming loose because she’s already removed the crown two other times. Now I’m worried. Am I stuck with mismatched teeth? I don’t want to risk the implant itself. Could I just whiten everything, crown included?

MaryAnne

Dear MaryAnne,

Using teeth whitening won’t help in this case. It will whiten your natural teeth, but the crown will stay the same shade, making the differences even more obvious. I’m very sorry that your dentist is treating you this way. She seems to be transferring her inability to match the crown for your dental implant to you. This isn’t your fault. Based on what you said, there are probably two problems going on with this. My first guess is this is a front tooth she’s trying to match. Those are trickier than others. Even top cosmetic dentists will do several try-ins before getting an exact match.

Notice I said try-in. There are temporary try-in pastes which allow you and the dentist to see what the dental crown will look like in place without using the permanent bonding materials that require her to grind your crown off every time you request a change. These are inexpensive. There are usually only two reasons a dentist doesn’t carry them. The first would be they don’t care what you think and will only look at it themselves. The second is they don’t know about it because they have not invested in cosmetic training, which has to be done in a post-doctoral setting. I believe your dentist falls into this latter category.

This leads me to her second problem. She’s just going by the standard Vita shade guides and expecting your tooth to be a perfect match. But, your teeth are between an A1 and A2. For back teeth, her method would work fine. However, a front tooth gets all the light when we smile, which shows the color and variations in striking clarity. The standard shade guide isn’t enough.

diagram of a dental color map This is an example of a color map a cosmetic dentist will send to the ceramist. Yes, it will have the basic shade, but there are also instructions for different tints to go in a variety of sections on the tooth, which changes the visual perception of the color. Our natural teeth aren’t one flat color. There are differences in opacity throughout the tooth. This is how you get a tooth to look natural and perfectly match its neighbor.

The truth is your dentist is in over her head. Ask for a partial refund and go elsewhere to get it done. See if you have an AACD accredited dentist in your state. They’re at the top of their field.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael WEiss.

Three Different Colored Teeth After Getting Porcelain Veneers

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Help me! I had four porcelain veneers placed on my teeth. As a result, I have three different colored teeth. My natural teeth are yellowish. The four porcelain veneers I received were all the same color, but now have a grayish tint in a splotchy way all the way down. I’m so frustrated because I paid a lot for these. What do I do?

Dania

Dear Dania,

A single porcelain veneer being placed on a tooth.

I’m sorry this has happened to you after investing in a beautiful smile. When you pay for a smile makeover, you expect it to be something you can be proud of. This isn’t what you received. My guess is your dentist is just your bread and butter general dentist, who hasn’t invested a lot of training in cosmetic work.

Unfortunately, this has its most negative impact on you. Most patients don’t realize that cosmetic dentistry isn’t a recognized specialty in the dental field. Any dentist can do it and it is up to them how much time they invest in training Think of it as an art form. If one person had a year of violin lessons and dabbled in practice and another person studied for years and practiced diligently, which one would you want to play at your wedding?

Getting Your Porcelain Veneers Done Right

There are some solutions to your situation. Let’s start with the visibility of your yellowed natural teeth. You received four porcelain veneers. Most smiles, including yours, are wider than four teeth. To keep that smile as uniform in appearance as possible, you have two options. One is to get enough porcelain veneers to cover all teeth which are visible when you smile. The second, if you can’t afford that many veneers, is to whiten your teeth. This is typically done before getting your veneers, so they can be made to match the color of your new white natural teeth as closely as possible. However, you can still get your teeth whitened now. The procedure will not damage your veneers.

As for your graying veneers. It sounds like the bonding isn’t well done on those teeth. Because it is splotchy, I believe there is food and bacteria getting caught between your teeth and the veneers. The only solution to this is to have them re-done. In fact, you need them to be replaced. Otherwise, your teeth will begin to decay under the porcelain veneers.

In some way, this is actually good news for you. It gives you a case for getting a refund from this dentist. Then, you can invest that money in a dentist who has done more training and has an artistic eye as well as the technical skill. My suggestion is you find an AACD accredited dentist. They’re the top cosmetic dentists in the country. They’ll give you a stunning smile.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Dental Bonding Disaster- Help!

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I had my four front teeth bonded. One of my front teeth sticks out too far over the second one. One of the lateral teeth is too far back and the other one has a big chip. He said he could fix this, but it’s ended up a disaster. First, he ground down the front overlapping tooth, then he added bonding material to the lateral teeth to fill in the missing depth and fix the chip. However, he insisted on doing them yellowish, even though I wanted them white. Now I feel they look ugly, plus the one he ground down is sharp and painful. I know there is no going back, but can this be fixed? My dentist seems to think he did a great job.

Adabelle

Dear Adabelle,

woman giving a thumbs up from the dental chair

Getting a beautiful smile requires a skilled cosmetic dentist

Even though I don’t have a picture of your smile and can’t give you specifics of what was done incorrectly, I do know what the major problem is. Your dentist is likely a very good family dentist who did his absolute best for you, but he was in over his head. Maybe he could have pulled off a basic dental bonding case. Maybe. Those are difficult to begin with because they need to be done free-hand. Your case requires an even more advanced dentist because of the structural issues that need to be dealt with.

This would need a dentist in the top 1-2% of cosmetic dentists, which requires significant training outside of general dental school. They’d need training in color theory, polishing the bonding material, and shaping the teeth. Your dentist obviously didn’t have this. Plus, a true cosmetic dentist would never be satisfied if his patient wasn’t thrilled with the results.

What you need is an AACD accredited dentist. These are the top cosmetic dentists in the country. In order to become accredited, they have to pass stringent exams, as well as have a large number of specific cases they’ve personally done evaluated for technical proficiency, beauty, and artistry. You can locate them by going to the website of the American Academy of Cosmetic Dentistry. Make sure you check you want an accredited or accredited fellow. Being a member isn’t enough.

Once You Have an Accredited Dentist

Once you’ve located an excellent cosmetic dentist in your area, you have two choices to get the smile you want.

Option 1: Re-do the Dental Bonding

Dental bonding is less expensive than the next option I’m going to make you aware of. When done by an expert cosmetic dentist it can blend in perfectly with your teeth, comfortably, with a natural translucency. If you want your bonding whiter than your adjacent teeth currently are, it will be in your best interest to whiten all of your teeth first. This will enable the dentist to blend the bonding material to your beautiful new white color.

Option 2: Get Porcelain Veneers

While these are more expensive than bonding, porcelain veneers can change anything about your smile— the shape, the size, the color, even the character. The other big benefit is they last much longer. Well taken care of porcelain veneers can last a lifetime. The dental bonding will have to be re-done every five years or so. Either one can be made beautifully.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Dental Bonding Staining

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I have dental composite bonding on all my front teeth. I have them re-done every three or four years. This latest set is only six months old and is starting to look yellow. Can this be polished to look right again or do I have to re-do them early? What would cause this to happen so quickly?

Priscilla

Dear Priscilla

Whether or not these can be polished to get rid of the stains depends on the nature of the staining itself. Unlike porcelain, which is hard and very stain resistant, composite dental bonding is fairly soft and is susceptible to two different types of staining.

Dental Bonding Staining One

an image of dental bonding on teeth stained by scratches

This first type of staining is surface stains. It happens because of tiny scratches on the bonding which allow it to pick up stains that are trapped there. You can tell these front teeth have been scratched because they’ve lost their glossy finish, instead they look matte. If you look at the adjacent natural teeth, they still have a gloss to them.

The good news is this type of staining can be fixed. If your dentist thoroughly polishes them, it will remove the scratches and stains, all while bringing the gloss back.

Dental Bonding Staining Two

Teeth with the two front teeth having stained dental bonding

Composite bonding is made from a solution of inorganic filler particles such as quartz or glass bound together in a plastic matrix. Because of that, it will absorb stains into its actual material. For instance, if you drink a lot of staining beverages, such as coffee or tea, it will penetrate the plastic and become a part of the bonding structure.

The picture above is a good example of this. Notice the two front teeth are much more stained than the surrounding teeth. This is absorbed staining. You can tell that (as opposed to scratch staining) because the teeth still have their shiny gloss. Notice the adjacent teeth, though stained, aren’t as stained as the bonded teeth. This is because your natural teeth are less susceptible to staining than composite bonding.

Unfortunately, this has to be re-done. There is no way to polish this out. Teeth whitening won’t work either. It will only whiten natural tooth structure. If that is the case, I’m going to highly suggest you switch to porcelain veneers on your teeth. Yes, veneers are more expensive initially. However, you are re-doing these every few years. Great porcelain veneers can last upwards of twenty plus years. They’re much more stain-resistant than bonding. In fact, they’re even more stain-resistant than your natural teeth.

Keeping Dental Bonding Stain-Free

1. Start with the right materials. You want to go to a skilled cosmetic dentist. They are more likely to stock microfill composite. This is possible to get polished completely giving it a high gloss and helping it resist stains.

Most general dentists just keep a generic composite which will never completely polish up to the gloss you need.

2. Avoid abrasive materials. I recommend anyone who has cosmetic work use Supersmile toothpaste. It’s specifically designed to chemically remove stains, instead of doing it with abrasives the way most toothpaste works.

3. Avoid staining beverages. If you must drink them, try not to let it sit on your teeth. Swallow immediately.

4. Make sure your hygienist doesn’t use anything like a prophy jet or pumice on your bonded teeth. It will destroy the glazing.

I hope this helps. Seriously consider switching to porcelain veneers.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Smile Makeover During Pregnancy

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I was planning on getting a smile makeover but just found out I’m pregnant. Can I go through with it or do I need to wait?

Avery

Dear Avery,

A woman smiling with a beauttiful smile

Congratulations on your upcoming blessing. Babies are the best. Whether or not you can go forward with treatment depends on a couple of things. The first is what procedures you were planning. The second is whether or not you’re in a high-risk category in your pregnancy.

Let’s start with the procedures.

Teeth Whitening

Getting your teeth whitened hasn’t been officially cleared for pregnant women. It’s not because there is evidence of it doing harm to the baby, it is because we’ve had no tests to say it doesn’t do harm. As you can imagine, there aren’t a lot of women lining up to have their unborn child be a test subject.

I’m sure you can find a dentist to do it for you. Just make sure you understand the risks. By that I mean we don’t yet know the risks.

Invisalign

These are clear aligners you wear over your teeth to straighten them. It’s perfectly safe to use during pregnancy. However, if you are prone to morning sickness and vomiting, you may find this an inconvenient time to straighten your teeth. The aligners have to be worn almost full-time, with the obvious time exceptions being during meals.

Vomiting will mean thoroughly cleaning out the aligners so you don’t get stuck with anything acidic in them. This will lead to massive decay.

Porcelain Veneers

Porcelain veneers are a safe procedure, even during pregnancy. The only chemical used would be the Lidocaine which is used for numbing during tooth preparation. Lidocaine is one of the medicines which has been FDA approved as safe to use during pregnancy. It’s even sometimes used during the delivery process.

The only cautionary tale I’d offer here is to make sure you see an expert cosmetic dentist or you will be disappointed with your smile makeover results.

All that being said, if you are in a high-risk pregnancy group, you’ll need to scrap everything I just said and talk to your obstetrician and get clearance on everything first. There will likely be special considerations.

Best of luck to you and your baby.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Porcelain Veneers During Pregnancy

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I’ve been saving up for a smile makeover for years. Now, when I finally have the full amount I needed I find out I’m pregnant. Is it safe for me to go forward with this or do I need to wait until after delivery?

Madison

Dear Madison,

A single porcelain veneer being placed

While there are some procedures which are not recommended in the first trimester, such as teeth whitening, porcelain veneers should be quite safe. The concern is about introducing chemicals to the baby. With porcelain veneers, the only thing you have to worry about is the anesthetic used. Fortunately, lidocaine has been tested and proved safe for use during pregnancy and even delivery. You and your baby should be fine.

Who Should Do Your Porcelain Veneers?

There is another important consideration— who should do your smile makeover. This isn’t a skill taught in dental school, nor is there a recognized specialty where dentists become graduates in the field. Instead, dentists with an interest in cosmetic dentistry have to take the initiative to get the proper training post-doctorally.

This makes it a little challenging for patients. How can they separate the sheep from the goats, so to speak? The easiest way to handle this is to find an AACD accredited dentist in a reasonable distance to you. These dentists have been tested vigorously for both their technical knowledge and their artistic ability and are among the top 1% of cosmetic dentists in the country.

They will give you a stunning smile.

If you can’t find an accredited dentist without a significant amount of travel, which you’re probably not keen on while pregnant, you still have options.

The mynewsmile.com website also recommends excellent cosmetic dentists. Not all of them have reached accreditation, but they’ve all been carefully screened for their ability to do beautiful smile makeovers. Most are on their way to accreditation.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Crowns for Chipped Tooth

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I’m not sure what to do and need some advice. I tripped and ended up chipping one of my front teeth. It’s not a huge chip, but it bothers me. My sister told me that dentists can fix chipped teeth even if you don’t have the broken piece. I went in to see my dentist. While he did say he could fix it, he said the solution would be for him to crown my two front teeth. I’m not too keen on that, especially because the other tooth is fine. When I asked him why both teeth, he said so that they could match. While I get that they need to match, it feels stupid to grind down two healthy teeth. I’m worried I’m letting my vanity get in the way of sensibility. What do you think? Crown the teeth or live with a small chip?

Elaine

Dear Elaine,

While I am sure your dentist is trying to do his best for you, I’m going to recommend you see someone else to repair this chipped tooth. Many dentists need to do two crowns on front teeth to match them, however, there are great cosmetic dentists who can match a single crown. If a crown were the right course of action, then another dentist could do the treatment just on one tooth.

The easiest way to find a highly skilled cosmetic dentist is to look on the website of the American Academy of Cosmetic Dentistry (aacd.com). They have a link to help patients find a cosmetic dentist. However, you want one who has reached the accreditation level. AACD accredited dentists are the top cosmetic dentists in the country. Any one of them can match a single porcelain crown to a front tooth.

All that being said, you really don’t even need a crown on the one tooth let alone two. Yes, a crown will cover the chip, but there are much less aggressive ways to repair it.

Dental Bonding for Chipped Teeth

before and after dental bonding

Dental bonding is the standard treatment for a chipped tooth.

The standard treatment for this is to have dental bonding placed on the tooth. This uses a composite resin which a cosmetic dentist will sculpt freehand onto the tooth. I wouldn’t push your family dentist to do this. It is obviously not a procedure he is familiar with and it would take some technical skill along with artistry to do it right.

Instead, I would find an excellent cosmetic dentist and have them do the procedure. You won’t have to completely switch dentists. You can still go to your family dentist for everything else,

There is a cosmetic consideration here (aside from the chipped tooth). Whatever color your dentist makes your bonding is permanent. If you are even considering having teeth whitening done on your teeth, it will save you money to do that before you have your bonding done.

Otherwise, your natural tooth structure will whiten but not your bonding. Then you’ll have to have the bonding re-done to match the newer color.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Should I Get a Second Opinion from a TMJ Specialist?

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I mentioned to my dentist that I wish my teeth were whiter. He mentioned because I have two crowns, I’d need to get those re-done first to match. He also looked closer at all my teeth and said my bite is off which means I have TMJ and need to get all the teeth crowned to fix it. This seems a bit excessive to me. Plus, it really surprised me to hear my bite was off. I had braces in my middle school years and didn’t feel like anything had changed since then. I’m thinking I should get a second opinion. What do you think?

Carla

Dear Carla,

Woman in pain with TMJ

I’m a little concerned with what I’m hearing. Let’s start with the teeth whitening. You don’t crown teeth to whiten them. Yes, you have a couple of crowns and they will have to be re-done to match but that will be AFTER your teeth are whitened. Not before. Otherwise, how will he know what shade of white to make them?

Now, about this crowning every tooth. This is called a full-mouth reconstruction and is usually reserved for more severe TMJ Cases. You haven’t mentioned any symptoms of TMJ Disorder. Without that, you should have serious doubts about this recommendation.

TMJ Symptoms

  • Jaw Pain
  • Popping in Your Jaw
  • Clicking in Your Jaw
  • Migraines, especially in the morning
  • Teeth Grinding or clenching

See a TMJ Dentist

I agree you need a second opinion. There isn’t a recognized specialty in TMJ Disorder. As such, there aren’t really any TMJ “Specialists”. However, there are dentists who have invested a great deal of time in studying TMJ Disorder and the different treatment options. Treatment is determined by first finding the underlying cause.

You want a dentist who has studied TMJ and occlusion at one of the reputable post-doctoral schools, such as The Dawson Academy, the Las Vegas Institute of Advanced Dental Studies, and The Kois Center.

Dentists who’ve studied at one of these schools are qualified to help diagnose your problem and come up with a good treatment. Most dentists prefer to start with the most conservative treatments first to see if that solves it before delving into something as invasive (and expensive) as a full-mouth reconstruction.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Solutions for a Tooth Gap

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I have a tooth gap which is really starting to bother me the older I get. I’m looking into solutions and wanted to opinion of a cosmetic dentist.

Ben

Dear Ben,

woman smiling with a tooth gap
There are several solutions for a gapped tooth

When you have a gapped tooth, there are three great solutions. Which you choose depends on what you’re going for with the rest of your smile.

Solution One: Invisalign

Invisalign Aligner
Invisalign Aligner

If you want to truly close the gap, you can use orthodontics. It’s no longer necessary for patients to wear unsightly and painful wire and metal braces. These days adults (and teens) prefer Invisalign. It uses clear aligners to straighten your teeth.

It has a secret benefit of allowing you to simultaneously whiten your teeth at the same time. Your dentist can provide you with the teeth whitening gel and the aligners will double as the trays.

Solution Two: Dental Bonding

before and after dental bonding

You can see from this case which Dr. Weiss did the gap is completely closed. He also reshaped her whole smile at the patients request. When done by a skilled cosmetic dentist dental bonding blends perfectly and looks completely natural.

You don’t have to have bonding done on the entire smile as this patient did. It can just close the gap. It can be matched to whatever color your teeth are. If you’re happy with the whiteness, just do the bonding. If you’d like them a little whiter, first whiten them, then have the bonding done after that is completed.

Solution Three: Porcelain Veneers

porcelain veneer being placed on a tooth
Porcelain Veneers

This is only a useful option if you’re unhappy with other aspects of your smile. Porcelain veneers can change everything about your smile.— the shape, the size, the color.

This is the go-to procedure for a complete smile makeover. It can give you the smile of your dreams. However, I would consider it an expensive over-treatment if all you want to do is close a tooth gap.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Tooth Whitening Has Always Been Popular

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The most popular Cosmetic Dentistry technique in the world is tooth whitening, but teeth bleaching certainly isn’t new, in fact, for thousands of years, people all over the planet resorted to some pretty unpleasant tactics when it came to their pearly whites.

The ancient Egyptians used ground pumice and wine vinegar to make a paste to whiten teeth while the ancient Romans preferred human urine. In the 16 th century, barbers got into the act adding tooth whitening to the mix. After a shave and a haircut, barbers would file down clients teeth before soaking with acid. This worked quite well for tooth whitening, but because this method of tooth whitening took the enamel as well, tooth decay was the price one had to pay for tooth bleaching.

These days, thanks to modern Cosmetic Dentistry, you do not have to do what your ancestors did to get that million-dollar smile. Over the counter tooth whitening products account for millions of dollars in sales every year, but because those products are made for the masses, you may not be getting the results that you should.

Talk to your Cosmetic Dentist in East Montgomery County about Venus® Teeth Whitening. Available from Dr. Michael Weiss this chair side tooth bleaching system could give you that movie star smile or natural smile that you always wanted.

Venus® Teeth Whitening is an in office treatment that is fast, effective and affordable. All it usually takes is just one in office treatment and subsequent at home bleaching sessions with your take-home tooth whitening kit to give you your new smile.

Your actual tooth whitening appointment starts with the application of a special hydrogen peroxide gel to your teeth. Almost immediately your teeth. Great care is taken so there is very little tooth sensitivity or discomfort.

Although your teeth are ready for a night out on the town, it does not stop there. Your Cosmetic Dentist, Dr. Weiss and his caring team will supply you with a tooth whitening kit so that you can maintain your new smile in the comfort of your home. All you have to do is fill your custom whitening trays with a special whitening gel and wear them for a set amount of time to keep your new gorgeous smile white and bright.

Stop wasting your money on over the counter tooth whitening products and schedule an appointment for Venus® Teeth Whitening with Dr. Weiss today.

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